| Muscle And Nerve Pa | |
|
971 Lakeland Drive Suite 560 Jackson MS 39216 | |
| (601) 982-9826 | |
| (601) 982-9826 |
| Full Name | Muscle And Nerve Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 971 Lakeland Drive, Jackson, Mississippi |
| Authorized Official Name and Position | Alan Rather Moore (PRESIDENT) |
| Authorized Official Contact | 6019829826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Muscle And Nerve Pa 971 Lakeland Drive Suite 560 Jackson MS 39216 Ph: (601) 982-9826 | Muscle And Nerve Pa 971 Lakeland Drive Suite 560 Jackson MS 39216 Ph: (601) 982-9826 |
| NPI Number | 1346370921 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 01/05/2023 |
| Certification Date | 01/05/2023 |
| Medicare PECOS PAC ID | 7810976735 |
|---|---|
| Medicare Enrollment ID | O20040715000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346370921 | NPI | - | NPPES |
| 426159735B | Other | MS | BCBS OF MS |
| 0530055 | Other | UNITED HEALTH CARE | |
| 06772854 | Medicaid | MS | |
| 169058500 | Other | US DEPT OF LABOR | |
| DC2890 | Other | GROUP RAILROAD MEDICARE | |
| P00159488 | Other | RAILROAD MEDICARE | |
| 09014965 | Medicaid | MS | |
| 130019995 | Other | RAILROAD MEDICARE | |
| 409393032 | Other | MS | BCBS OF MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 18286 (Mississippi) | Primary |
| Provider Name | Alan R Moore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245330133 PECOS PAC ID: 3678552882 Enrollment ID: I20040720000182 |
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